This study evaluated 30 patients with unilateral subcondylar fractures of the mandible that were treated with open reduction and internal fixation (ORIF). Computed tomography (CT) scans were used to assess morphological changes in the condyles post-operatively and compared to the unoperated side. Clinical dysfunction was also evaluated using the Helkimo index. The results found greater changes in condylar length, angulation and joint space measurements on the operated side on CT. Mild to moderate clinical dysfunction was observed in some patients based on the Helkimo index. A correlation was seen between the severity of morphological changes on CT and increased clinical dysfunction. The study concluded that ORIF can lead to structural changes in the operated

1. Clinical and morphological
evaluation of condyle in unilateral
subcondylar fractures treated by
open reduction and internal
fixation: A Cross-sectional study.
Presenter: Dr. Anita Biswalo,
MDS (VMSDC, Salem),
Fellowship in Maxillofacial Trauma (AMRI Hospitals)

2. CONDYLE
• Diarthroidal joint
• Articulates with TMJ
• Associated to external auditory canal and
middle cranial fossa
• Reducing loads on the overlying bone and
contributing to bone remodeling.
• Attached to pterygoid muscle and temporalis

4. RESEARCH QUESTION ?
Does mandibular condyle
undergoes morphological changes
after ORIF ?
If so, does it cause clinical
dysfunction ?
Does the structural changes in
condyle and the clinical dysfunction
corelate ?

5. METHODOLOGY
• 30 cases
• Post-operative 6 months follow up
• CT scans for radiological evaluation
of condyles of mandible (Choi et al
3013).
• Helkimo Index for clinical
evaluation of Temporomandibular
joint.
INCLUSION EXCLUSION
• Unilateral
subcondylar
fractures
• Condylar fractures
treated with ORIF
• Condylar fractures
+ mandible
fractures
• Bilateral condylar
fractures
• High condylar
fractures
• Condylar fractures
treated
conservatively
• Patients with pre-
existingTMJ
disorders

11. OBSERVATION
CT evaluations of un-
operated side condyle
vs CT evaluations of
operated side condyle
Corelating Helkimo
index and CT
evaluations

12. RESULTS
ON AXIAL SECTION,
• Condylar distance OP < UN-OP
• Condylar length OP > UN-OP
• Condylar angulation OP > UN-
OP

13. ON SAGITTAL SECTION,
• Superior joint space 1 (S1) OP >
UN-OP
• Superior joint space 2 (S2) OP >
UN-OP
• Superior joint space 3 (S3) OP <
UN-OP

14. ON CORONAL SECTION,
• Posterior distal stump
angulation OP > UN-OP

16. CONDYLAR LENGTH POSTERIOR DISTAL STUMP ANGULATION

17. • In this study, 2 cases had moderately dysfunction Helkimo index and 13 mild dysfunction Helkimo Index.
• Among mandibular condyle fracture parameters, restricted TMJ was observed in 2 (13.3%) cases of operates site.
• No painful mandibular movement was observed in any case of both the sites.
• Muscle pain was observed in 1 (6.7%) cases of operates site and nil cases of unoperated site.
• No painful TMJ was observed in any case of both the sites.
• The mean condylar length at operated site was 1.86±0.21 cm while at unoperated site this length was 1.79±0.21
cm. Therefore, a difference of 0.07±0.11 cm was observed which was statistically significant (p=0.024)
• The mean Posterior Distal Stump Angulation at operated site was 170.59±4.38 degrees while at unoperated
site this angulation was 167.93±4.34 degrees. Therefore, a difference of 2.66±4.54 degrees was observed which
was statistically significant (p=0.040).

18. CONCLUSION
Radiologically, structural
changes on operated side
condyle were clearly
higher, when compared
the same with the values
on the unoperated side
condyle.
On corelating clinical
and radiological
values, structural
changes presented
with more severity of
TMJ dysfunction.

19. DISCUSSION
Changes in
condylar
morphology
after ORIF
due to
Intraoperative injury
Soft tissue adjustments
Increased load on the operated
side
Dental component
TMJ changes

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